Situation 1 - Jimmy developed this goal for hospitalization. "To get a handle on my nervousness." The nurse is going to collaborate with him to reach his goal. Jimmy was admitted to the hospital because he called his therapist that he planned to asphyxiate himself with exhaust from his car but frightened instead. He realized he needed help.
1. The nurse recognized that Jimmy had conceptualized his problem and the next priority goal in the care plan is:
a. help the client find meaning in his experience
b. help the client to plan alternatives
c. help the client cope with present problem
d. help the client to communicate
2. The nurse is guided that Jimmy is aware of his concerns of the "here and now" when he crossed out which item from this "list of what to know"
a. anxiety laden unconscious conflicts
b. subjective idea of the range of mild to severe anxiety
c. early signs of anxiety
d. physiological indices of anxiety
3. While Jimmy was discussing the signs and symptoms of anxiety with his nurse, he recognized that complete disruption of the ability to perceive occurs in:
a. panic state of anxiety
b. severe anxiety
c. moderate anxiety
d. mild anxiety
4. Jimmy initiates independence and takes an active part in his self care with the following EXCEPT:
a. agreeing to contact the staff when he is anxious
b. becoming aware of the conscious feeling
c. assessing need for medication and medicating himself
d. writing out a list of behaviors that he identifies as anxious
5. The nurse notes effectiveness of Interventions in using subjective and objective data in the:
a. initial plans or order
c. problem list
d. progress notes
Situation 2 - A research study was under taken in order to identify and analyze a disabled boy's coping reaction pattern during stress.
6. This study which is a depth study of one boy is a:
a. case study
b. longitudinal study
c. cross-sectional study
d. evaluative study
7. The process recording was the principal tool for data collection. Which of the following is NOT a part of a process recording?
a. Non verbal narrative account
b. Audio and interpretation
c. Audio-visual recording
d. Verbal narrative account
8. Which of these does NOT happen in a descriptive study?
a. Exploration of relationship between two or more phenomena
b. Exploration of relationships between two or more phenomena
c. Manipulation of phenomenon in real life context
d. Manipulation of a variable
9. The investigator also provided the nursing care of the subject. The investigator is referred to as a/an.
b. Observer researcher
10. To ensure reliability of the study, the investigator analysis and interpretations were:
a. subjected to statistical treatment
b. correlated with a list coping behaviors
c. subjected to an inter-observe agreement
d scored and compared standard criteria
Situation 3 - During the morning endorsement, the' outgoing nurse informed the nursing staff that Regina, 5 years old, was given Flurazepam (Dalmane) 15 mg at 10:00pm because she had trouble going to sleep. Before approaching Regina, the nurse read the observation of the night nurse.
11. Which of the following approaches of the nurse validates the data gathered?
a. "I learned that you were up till ten last night, tell me what happened before you were finally able to sleep and how was your sleep?"
b. "Hmm...You look like you had a very sound sleep. That pill you were given last night is effective isn't it?"
c. "Regina, did you sleep we!!?"
d. "Regina, how are you?"
12. Regina is a high school teacher. Which of these information LE^ST communicate attention and care for her needs for information about her medicine?
a. Guided by a medication teaching plan go over with her the purpose, indications and special instructions, about the medication and provide her a checklist
b. Provide a drug literature
c. Have an informal conversation about the medication and its effects
d. Ask her what time she would like to watch the informative video about the medication
13. The nurse engages Regina in the process of mutual inquiry to provide an opportunity for Regina to
a. face emerging problems realistically
b. conceptualize her problem
c. cope with her present problem
d. perceive her participation in an experience
14. Which of these responses indicate that Regina needs further discussion regarding special instructions?
a. "I have to take this medicine judiciously."
b. "I know 1 will stop taking the medicine when there is an advice form the doctor for me to discontinue."
c. "I will inform you and the doctor any untoward reactions I have."
d. "I like taking this sleeping pill. It solves my problem of insomnia. I wish I can take it for life."
15. Regina commits to herself that she understood and will observe all the medicine precautions by;
a. affixing her signature to the teaching plan that she has understood the nurse
b. committing what she learned to her memory
c. verbally agreeing with the nurse
d. relying on her husband to remember the precautions
Situation 4 - The nurse-patient relationship is a modality through which the nurse meets the client's needs.
16. The nurse's most unique tool in working with the emotionally ill client is his/her:
a. theoretical knowledge
b. personality make up
c. emotional reactions
d. communication skills
17. The psychiatric nurse who is alert to both the physical and emotional needs of clients is working from the philosophical framework that states:
a. All behavior is meaningful, communicating a message or a need
b. Human beings are systems of interdependent and interrelated parts
c. Each individual has the potential for growth and change in the direction of positive mental health
d. There is a basic similarity among all human beings
18. One way to increase objectivity in dealing with one’s fears and anxieties is through the process of:
19. All of the following response are non therapeutic. Which is the MOST direct violation of the concept, congruence of behavior?
a. Responding in a punitive manner to the client
b. Rejecting the client as a unique human being
c. Tolerating all behavior in the client
d. Communicating ambivalent messages to the client
20. The rnentally ill person responds positively to the nurse who is warm and caring. This demonstration of the nurse’s role as:
b. mother surrogate
d. socializing agent
Situation 5 - The nurse engages the client in a. nurse-patient interaction.
21. The best time to inform the client about terminating the nurse-patient relationship is
a. when the client asks, how long one relationship would be
b. during the working phase
c. towards the end of the relationship
d. at the start of the relationship
22. The client says, "I want to tell you something but can you promise that you will keep this, a secret?" A therapeutic response of the nurse is:
a. "Yes, our interaction is confidential provided the information you tell me is not detrimental to your safety."
b. "Of course yes, this is just between you and me. Promise!"
c. "Yes, it is my principle to uphold my client's rights."
d. "Yes, you have the right to invoke confidentiality of our interaction."
23. When the nurse respects the client's self-disclosure, this is a gauge for the nurse's:
24. Rapport has been established in the nurse-client interaction time. I am committed to have this time available for us while you are at the hospital and ends after your discharge."
a. "The best time to talk is during the nurse-client interaction time. I am committed to have this time available for us while you are at the hospital and ends after your discharge."
b. "Yes, if you keep it confidential, this is part of privileged communication."
c. "I am committed for your care."
d. "I am sorry, though I would want to, it is against hospital policy."
25. The client has not been visited by relatives for months. He gives a, telephone number and requests the nurse to call. An appropriate action of the nurse would be:
a. Inform the attending psychiatric about the request of the client
b. Assist the client to bring his concern to the attention of the social worker
c. "Here (gives her mobile phone). You may call this number now."
d. Ask the client what is the purpose of contacting his relatives
Situation 6 - Camila, 25 years old, was reported to be gradually withdrawing and isolating herself from friends and family members. She became neglectful of her personal hygiene. She was observed to be talking irrelevantly and incoherently. She was diagnosed as schizophrenia
26. The past history of Camila would most probably reveal that her premorbid personality is:
27. Camila refuses to relate with others because she:
a. is irritable
b. feels superior of others
c. anticipates rejection
d. is depressed
28. Which of the following disturbances in interpersonal relationships MOST often predispose, to the development of schizophrenia?
a. Lack of participation in peer groups
b. Faulty family atmosphere and interaction
c. Extreme rebellion towards authority figures
d. Solo parenting
29. Camila's indifference toward the environment is a compensatory behavior to overcome:
a. Guilt feelings
c. Narcissistic behavior
d. Insecurity feelings
30. Schizophrenia is a/an:
a. anxiety disorder
Situation 7 - Salome, 80 year old widow, has been observed to be irritable, demanding and speaking louder than usual. She would prefer to be alone and take her meals by herself, minimized receiving visitors al home and no longer bothers to answer telephone calls because of deterioration of her hearing. 'She was brought by her daughter to, the Geriatic clinic for assessment and treatment.
31. The nurse counsels Salome's daughter that Salome's becoming very loud and tendency to become aggressive is a/an:
a. beginning indifference to the world around her
b. attempt to maintain authoritative role
c. overcompensation for hearing loss
d. behavior indicative of unresolved repressed conflict of the part
32. A nursing diagnosis for Salome is:
a. sensory deprivation
b. social isolation
c. cognitive impairment
d. ego despair
33. The nurse will assist Salome and her daughter to plan a goal which is:
a. adjust to the loss of sensory and .perceptual function
b. participate in conversation and other social situations
c. accept the steady loss of hearing that occurs with aging
d. increase her self-esteem to maintain her authoritative role
34. The daughter understood, the following ways to assist Salome meet her needs and avoiding which of the following:
a. Using short simple sentences
b. Speaking distinctly and slowly
c. Speaking at eye level and having the client's attention
d. Allowing her to take her meals alone
35. Salome was fitted a hearing aid. She understood the proper .use and wear of this device when she ways that the battery should be functional, the device is turned on and adjusted to a:
a. therapeutic level
b. comfortable level
c. prescribed level
d. audible level
Situation 8 - For more than a month now, Cecilia is persistently feeling restless, worried and feeling as if something dreadful is going to happen. She fears being alone in places and situations where she thinks that no one might come to rescue her just in case something happens to her.
36. Cecilia is demonstrating:
37. Cecilia's problem is that she always sees and thinks negative hence she is always fearful Phobia is a symptom described as:
38. Cecilia has a lot of irrational thoughts: The goal of therapy is to modify her:
39. Cognitive therapy is indicated for Cecilia when she is already able to handle anxiety reactions. Which of the following should the nurse implement?
a. assist her in recognizing irrational beliefs, and thoughts
b. help find meaning in her behavior
c. provide positive reinforcement for acceptable behavior
d. administer anxiolytic drug
40. After discharge, which of these behaviors indicate a positive result of being able to overcome her phobia?
a. she read a book in the public library
b. she drives alone along the long expressway
c. she watches television with the family in the recreation room
d. she joint an art therapy group
Situation 9 - it is the first day of clinical experience of nursing students at the Psychiatry Ward- During the orientation, the nurse emphasizes that the team members including nursing students are legally responsible to safeguard patient's records from loss or destruction or from people not authorized to bead it.
41. It is unethical to tell one's friends and family member’s data bout patients because doing so is violation of patients’ rights to:
a. Informed consent
c. Least restrictive environment
d. Civil liberty
42. The nurse must see to it that the written consent of mentally ill patients must be taken from:
b. Social worker
c. Parents or legal guardian
d. Law enforcement authorities
43. In an extreme situation and when no other resident or intern is available, should a nurse receive, telephone orders, the order has to be correctly written and signed by the physician within.
a. 24 hours
b. 36 hours
c. 48 hours
d. 12 hours
44. The following are SOAP (Subjective - Objective - Analysis - Plan) statements on a problem: Anxiety about diagnosis. What is the objective data?
a. Relate patient's feelings to physician initiate and encourage her to verbalize her fears give emotional support by spending more time with patient, continue to make necessary explanations regarding diagnostic test.
b. Has periods of crying, frequently verbalizes fear of what diagnostic tests will reveal
c. Anxiety due to the unknown
d. "I’m so worried about what else they'll find wrong with me"
45. Nursing care plans provide very meaningful data for the patient profile and initial plan because the focus is on the:
a. Summary of chronological notations made by individuals health team members
b. Identification of patient's responses to medical diagnosis and treatment
c. Patient's responses to health: and illness as a total person in interaction with the environment
d. Step procedures for the management of common problems
Situation 10 - Marie is 5 ½ years old and described by the mother as bedwetting at night.
46. Which of the following is the MOST common physiological cause of night bedwetting?
a. deep sleep factors
b. abnormal bladder development or structure problems
c. infections familial and genetic factors
47. All of the following, EXCEPT one comprise the concepts of behavior therapy program:
a. reward and punishment
d. placebo as a form treatment
48. The help Marie who bed wets at night practice acceptable and appropriate behavior, it is important for the parents to be consistent with the following approaches EXCEPT:
a discipline with a king attitude
b matter of fact in handling the behavior
c. sympathize for the child
d. be lowing yet firm
49. A therapeutic verbal approach that communicates strong disapproval is:
a. You are supposed to get up and go in the toilet when you feel you have to go and did not. The next time you bed wet, I’ll tell your friends and hand your sheets out the window for them to see."
b. "You are supposed to get up and go in the toilet when you feel you have to go and you did not. I expect you to from now on without fail."
c. "If you bed wet, you will change your bed linen and wash the sheets."
d. "If you don't make an effort to control your bedwetting, I'd be upset and disappointed."
50. During your conference, the parent inquires how to motivate Marie to be dry in the morning. Your response which is an immediate intervention would be:
a. Give a star each time she wakes up dry and every set of five stars, give a prize
b. Tokens make her materialistic at an early age. Give praise and hugs occasionally
c. What does you child want that you can give every time he/she wakes up dray in the morning
d. Promise him/her a long awaited vacation after school is over.
Situation 11 - The nurse is often met with t-he following situations when clients become angry and hostile.
51. To maintain a therapeutic eye contact and body posture while interacting with angry and aggressive individual, the nurse should:
a. keep an eye contact while staring at the client
b. keep his/her hands behind his/her back or in one's pocket
c. fold his/her arms across his/her chest
c. keep an "open" posture, e.g. Hands by sides but palms turned outwards
52. During the pre-interaction phase of the N-P relationship/the nurse recognizes this normal INITIAL reaction to an assaultive or potentially assaultive person.
a. To remain and cope with the incident
b. Display empathy towards the patient
c. To call for help from the other members of the team
d. To stay and fight or run away
53. Which of the following is an accurate way of reporting and recording an incident?
a. "When asked about his relationship with his father, client became anxious."
b. "When asked about his relationship with his father, client clenched his jaw/teeth made a fist and turned away from the nurse."
c. "When asked about his relationship with his father, client was resistant to respond."
d. "When asked about his relationship with his father, his anger was suppressed."
54. To encourage thought. Which of the following approaches is NOT therapeutic?
a. "Why do you feel angry?"
b. "When do you usually feel angry?"
c. "How do you usually express anger?"
d. "What situations provoke you to be angry?"
55. A patient grabs a chair and about to throw it. The nurse best responds saying.
a. "Stop! Put that chair down."
b. "Don't be silly."
c. "Stop, the security will be here in a minute."
d. "Calm down."
Situation 12 - Nursing care for the elderly.
56. In planning care for a patient with Parkinson's disease, which of these nursing diagnoses should have priority?
a. potential for injury
b. altered nutritional state
c. ineffective coping
d. altered mood state
57. A healthy adaptation to aging is primarily related to an individual.
a. Number of accomplishments
b. Ability to avoid interpersonal conflict
c. Physical health throughout life
d. Personality development in his life span
58. The frequent use of the older client's name by the nurse is MOST effective in alleviating which of the following responses to old age?
59. An elderly confused client gets out of bed at night to go to the bathroom and tries to go to another bed when she returns. The MOST appropriate action the nurse would take is to:
a. Assign client to a single room
b. Leave a light on all night
c. Remind client to call the nurse when she wants to get up
d. put side rails on the bed
60. An elderly who has lots of regrets, unhappy and miserable1 is experiencing:
Situation 13 - Graciela 1 ½ year old is admitted the hospital from the emergency room with a fracture of the left femur due to a Tall down a flight of stairs. Graciela is placed oh Bryant's traction.
61. While on Bryant's traction, which of these observations of Graciela and her traction apparatus would indicate a decrease in the effectiveness of her traction?
a. Graciela's buttocks are resting on the bed
b. The traction weights are hanging 10 inches above the floor
c. Graciela's legs are suspended at a 90 degree angle to her trunk
d. The traction ropes move freely through the pulley
62. The nurse notes that the fall might also cause a possible head injury. She will be observed for signs of increased intracranial pressure which include:
a. Narrowing of the pulse pressure
c. Periorbital edema
d. A positive Kernig's sign
63. Graciela is assessed to have no head injury. The Bryant's traction is removed. A plaster of Paris his spica is applied. Which of these finding as a concern of immediate attention that must be reported to the physician immediately?
a. Graciela is scratching the cast over her abdomen
b. The toes of Graciela's left foot blanch when the nurse applies pressure on them
c. Graciela's cast is still damp
d. The nurse is unable to insert a finger under the edge of Graciela's cast on her left foot
64. Part of discharge plan is for the nurse to give instructions about the care of Graciela's cast to the mother. Which of these statements indicate that the mother understood an important aspect of case care?
a. I will use white shoe polish to keep the cast neat
b. I will place plastic sheeting around the perineal area of the cast
c. I will use cool water to wash the cast
d. I will reinforce cracked areas on the cast with adhesive tape
65. The nurse counsels Graciela's mother ways to safeguard safety white providing opportunities of Graciela to develop a sense of:
Situation 14 - Jolina is an 18 year old beginning college student. Her mother observed that she is having problems relating with her friends. She is undecided about her future. She has lost insight, lost interest in anything and complained and complained of constant tiredness.
66. Jolina is out on antidepressant drugs. These drugs act on the brain chemistry, therefore they would be useful in which type of depression?
a. exogenous depression
b. neurotic depression
c. endogenous depression
d. psychotic depression
67. This is a tricyclic antidepressant drug:
a. Venlafaxine (Effexor)
c. Setraline (Zoloft)
b. Flouxetine (Prozac)
d. Imipramine (Tofranil)
68. After one week of antidepressant medication, Jolina still manifests depression. The nurse evaluates this as;
a. Unusual because action of antidepressant drug is immediate
b. Unexpected because therapeutic effectiveness takes within a few days
c. Expected because therapeutic effectiveness takes 2-4 weeks
d. Ineffective result because perhaps the drug's dosage is inadequate
69. Jolina continues to verbalize feeling sad and hopeless. She is not mixing well with other clients. One of the nurse's important consideration for Jolina Initially is to:
a. Formulate a structured schedule so she is able to channel her energies externally
b. Let her alone until she feels like mingling with others
c. Encourage her to join socialization hour so she will start to relate with others
d. Encourage her to join group therapy with other patients
70. During the predischarge conference, the nurse suggests vocational guidance because it should help Jolina to:
a. Find a good job
b. Make some decision about her future
c. Realistically assess her assets and limitations
d Solve her own problems
Situation 15 - Group Approach" in Nursing.
71. Membership dropout generally occurs in group therapy after a member:
a. Accomplishes his goal in joining the group
b. Discovers that his feelings are shared by the group members
c. Experiences feelings of frustration in the group
d. Discusses personal concerns with group members
72. Which of the following questions illustrates the group role of encourager?
a. What were you saying?
b. Who wants to respond next?
c. Where do you go from here?
d. Why haven't we heard from you?
73. The goal of remotivation therapy is to facilitate:
74. The treatment of the family as a unit is based on the belief that the family:
a. is a social system and all the members are interrelated components of that system
b. as a unit of society needs the opportunity to change its own destiny
c. who has therapy together will tend to remain together
d. is "contaminated" by the presence of deviant member and all members need treatment
75. The working phase in therapy group is usually characterized by which of the following?
Situation 16 - The mental health - psychiatric nurse functions in a variety of setting with different types of clients.
76. Poverty as reflected in prevalence of communicable diseases, malnutrition and social ills such as street children, homeless and prostitution is a predisposing factor to mental illness. A community approach to cope with this problem is for the nurse to support:
a. aggressive family planning methods
b. provision of social welfare benefits for the poor
c. social action
d. free clinics and more hospitals
77. The MOST cost effective way to meet the mental health needs of the public is through programs with a priority goal of:
78. Lorelle upon discharge was referred to a volunteer group where she has learned to read patterns, cut out fabric and use a sewing machine to make simple outfits that will help her earn in the future. What type of activity therapy is this?
a. Recreational therapy
b. Art therapy
c. Vocational therapy
d. Educational therapy
79. In a residential treatment home for adolescent girl's the clients were becoming increasingly tense and upset because of shortening of their recreation time. To die escalate possible anger and aggression among the clients it is BEST to play:
a. religious music
b. relaxation music
c. dance music
d. rock music
80. The parents of special children who are behaviorally disturbed need mental health education. Which of these topics would the school nurse consider as priority for their parents’ class?
a. Drug education
b. Child abuse
c. Effective parenting
d. Sex education
Situation 17 - Nurse's in all practice areas are likely to come in contact with clients suffering from acute or chronic drug abuse.
81. The psychodynamic therapy of substance abuse is based upon the premise that drug abuse is:
a. a common problem brought about by socioeconomic deprivation
b. caused by multiplicity of factors
c. predisposed by an inability to develop appropriate psychological resources to manage developmental stresses
d. due to biochemical factors
82. Being in contact with reality and the environment is a function of the:
d. super ego
83. Substance abuse is different from substance dependence is than, substance dependence:
a. includes characteristics of adverse consequences and repeated use
b. requires long term treatment in a hospital based program
c. produces less severe symptoms than that of abuse
d. includes characteristics of tolerance and withdrawal
84. During the detoxification stage, it is a priority for the nurse to:
a. teach skills to recognize and respond to health threatening situations
b. increase the client's awareness of unsatisfactory protective behaviors
c. implement behavior modification
d. promote homeostasis and minimize the client’s withdrawal symptoms
85. Commonly known as "shabu" is:
a. Cannabis Sativa
b. Lysergic add diethylamide
c. Methylenedioxy, methamphetamine
d. Methamphetamine hydrochloride
Situation 18 - It is common that client ask the nurse personal questions.
86. Anticipation of personal questions is given adequate attention during which phase of the nurse patient relationship?
a. Orientation phase
b. Working phase
c. Pre-interaction phase
d. Termination phase
87. The client asks for the nurse's telephone number, which of these responses is NOT appropriate?
a. "it is confidential I just don't give it to anyone."
b. "What would you do with my number if I give it to you?"
c. "If I say. No to your request, what are your thoughts about it?”
d. "Are you asking for an official number of the hospital/clinic for your reference?"
88. When the client asks about the family of the nurse the MOST appropriate response is:
a. Avoid the situation and redirect the client's attention
b. Give a brief and simple response and focus on the client
c. "Why don't we talk about your family instead?"
d. Introduce another topic like the client's interests
89. When the nurse is asked a personal question, which of these reactions indicate a need her to introspect?
a. The client is simply curious
b. His/her right to privacy is being intruded
c. The client knows no other way to begin a conversation
d. Some patients are like children in seeking recognition from the nurse
90. It is 10 o'clock of your watch. The client asks, "What time is it?" The nurse's appropriate response is:
a. "Are you bored?"
b. "It is 10 o’clock."
c. "Why do you ask?"
d. "Guess, what time is it?"
Situation 19 - Ricky is a 12 year old-boy with Down’s syndrome. He stands 5' ½" and weight 100 lbs. He is slim and walks sluggishly with a limp. He wears a neck brace as support for his neck. X - ray of cervical spine showed "subluxation of CI in relation to C2 with cord compression." He attends a school for special education.
91. The classroom teacher consults the school for guidance on how to take care of Ricky while inside the, classroom. The nurse considers as priority, Ricky's:
a. Physiological needs
b. Need for self-esteem
c. Needs for safety and Security
d. Needs for belonging
92. Ricky's mother visited the school nurse. She asked, " What should I do when Ricky fond his genitalia?" Appropriate response of the nurse is for the mother to:
a. Divert Ricky's attention and engage him in satisfying activities
b. Tell Ricky that it is wrong to keep fondling his genitalia
c. Ignore Ricky's behavior because he will outgrow it later
d. Engage him in computer TV games that engage his hands
93. The nurse has one on one health education sessions with Ricky's mother. The mother understood that for her son to learn to cope and be independent, she should constantly provide activities for Ricky to be able to:
a. socialize with people
b. eventually go to school alone
c. select and prepare his own food
d. do activities of daily living
94. All of the following activities are appropriate for Ricky EXCEPT:
a. Working with clay
b. Competitive sports
c. Preparing and cooking simple menu
d. Card and table games
95. Ricky's IQ falls within the range of 50-55. He can be expected to:
a. Profit from vocational training with moderate supervision
b. Live successfully in the community
c. Perform simple tasks in closely supervised settings
d. Acquire academic skills of 6th grade; level
Situation 20 - The abuse of dangerous drug is a serious public health concern that nurses need to address,
96. The nurse should recognize that the unit primarily responsible for education and awareness of the members of the family on the ill effects of dangerous drugs is the:
a. law enforcement agencies
97. A drug dependent utilizes this defense mechanism and enables him to forget shame and pain.
98. This drug produces mirthfulness, fantasies, flight of ideas, loss of train of thought, distortion of size, distance and time, and "bloodshot eyes", due to dilated pupils.
99. The nurse evaluates that-.her health teaching to a group of high school boys is effective if these students recognize which of the following dangers of inhalant abuse.
a. Sudden death from cardiac or respiratory depression
b. Danger of acquiring hepatitis or AIDS
c. Experience of "blackout"
d. Psychological dependence after prolonged use
100. The mother of a drug dependent would never consider referring her son to a drug rehabilitation agency because she fears her son might just becomes worse while relating with other drugs users. The mother's behavior can be described as:
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